Changes in cell adhesion molecule concentrations in the lower uterine segment during preterm delivery

Objective: Cell adhesion molecules play a central role in the extravasation of neutrophils with inflammation. We measured tissue concentrations of cel l adhesion molecules in the lower uterine segment at preterm delivery. Methods: Tissue specimens from the lower uterine segment were obtained in 2 0 women undergoing nonelective preterm cesarean section. Concentrations of the intracellular adhesion molecule-1 (ICAM-1), endothelial leukocyte adhes ion molecule-1 (ELAM-1), vascular cell adhesion molecule-1 (VCAM-1), and pl atelet endothelial cell adhesion molecule-1 (PECAM-1) were measured with en zyme immunoassays in protein extracts of the tissue specimens. The patients were stratified according to cervical dilatation (< 2, 2 - <4, and greater than or equal to 4 cm) and duration of labor less than or equal to 6, > 6 - 12, and > 72 h) at the time of delivery. Results: The median concentration of ICAM-1 was significantly higher at gre ater than or equal to 4 cm than at 2 - <4cm dilatation (5.34 ng/mg vs. 3.76 ng/mg, P < 0.01). After > 12 h of labor the median concentrations of ICAM- 1 and ELAM-1 were significantly higher than after less than or equal to 6 h (7.18 vs. 2.91 ng/mg and 0.23 vs. 0.11 ng/mg, respectively; P < 0.05). Conclusion: At preterm delivery the expression of adhesion molecules in the lower uterine segment increases with cervical dilatation and with the dura tion of labor. This supports an inflammatory component in the genesis of pr eterm delivery.